Citation NR: 9622842 Decision Date: 08/08/96 Archive Date: 08/16/96 DOCKET NO. 93-04 130 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in No. Little Rock, Arkansas THE ISSUE Entitlement to service connection for a cardiovascular disorder. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Melissa F. Marquez, Associate Counsel INTRODUCTION The appellant had active service from August 1948 to April 1949. This matter originally came before the Board of Veterans' Appeals (hereinafter Board) on appeal from a June 1991 rating decision of the North Little Rock, Arkansas Regional Office (hereinafter RO), of the Department of Veterans Affairs (hereinafter VA), which denied entitlement to service connection for a cardiovascular disorder. Following a November 1994 Remand, this case was returned to the Board in June 1996, and now ready for appellate review. The Board's decision is limited to the issue developed for appellate review. The Board notes that it is still unclear from the appellant’s current statements on file whether he desires to apply to reopen his claim for service connection for a psychiatric disorder. If so, the appellant should contact the RO and assert such claim with specificity, and the RO should then take appropriate action. Kellar v. Brown, 6 Vet.App. 157 (1994). CONTENTIONS OF APPELLANT ON APPEAL The appellant contends, in essence, that he is entitled to service connection for a cardiovascular disorder, to include rheumatic valvular heart disease. He argues that he suffered from rheumatic fever as a child which resulted in rheumatic heart disease due to in-service stressors. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991 & Supp. 1995), has reviewed and considered all of the evidence and material of record in the appellant's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is against the appellant’s claim for service connection for a cardiovascular disorder. FINDINGS OF FACT 1. All available, relevant evidence necessary for disposition of the appeal has been obtained by the RO. 2. A cardiovascular disorder did not exist prior to active service, and was not present during active duty, or proximate thereto. 3. Competent credible evidence demonstrates that the appellant was initially diagnosed with a cardiovascular disorder in the early 1960’s, and it has not been shown by competent credible evidence on file to be attributable to active duty, or to any event or occurrence therein. 4. The appellant does not have a cardiovascular disorder attributable to his military service. CONCLUSION OF LAW A cardiovascular disorder was not incurred in or aggravated by service, nor can a cardiovascular disorder be presumed to have been so incurred. 38 U.S.C.A. §§ 1101, 1112, 1113, 1131, 1137, 1153, 5107 (West 1991 & Supp. 1995); 38 C.F.R. §§ 3.303, 3.306, 3.307, 3.309 (1995). REASONS AND BASES FOR FINDINGS AND CONCLUSION Initially, we find that the appellant's claim for service connection for a cardiovascular disorder is well grounded within the meaning of 38 U.S.C.A. § 5107(a), in that he has presented a claim which is plausible. This being so, we must examine the record to determine whether the VA has a further obligation to assist in the development of facts pertinent to his claim. 38 U.S.C.A. § 5107(a). After reviewing the record, we are satisfied that all relevant facts have been properly developed and that no useful purpose would be served by remanding the case with instructions to provide additional assistance to the appellant. All available service medical and personnel records are associated with the claims folder, as the National Personnel Records Center (NPRC) has reported that no additional service records can be found or reconstructed at this time. Moreover, the current record contains all reported and available VA and private treatment records of the appellant dated from the 1960’s, to include private treatment records from Siloam Springs Memorial Hospital; The Texas Heart Institute; Washington Regional Medical Center; Gravette Medical Center; Springdale Memorial Hospital; Oak Hill Hospital; St. John’s Regional Health Center; Maricopa County Hospital; all available records associated with a claim for disability compensation with the Social Security Administration (SSA) in 1963; and an April 1963 statement from L.S. Shumate, M.D.; VA treatment records dated in 1963, and from 1991 to 1994; and VA examination reports dated in 1963 and 1995. In this regard, we note that Scaggs Memorial Hospital and Magnum Copper Mine, Inc. reported that no treatment records of the appellant were available, and both the appellant and Maria Meese have reported that clinical records from Dr. Shumate and a Dr. Cottrell have been destroyed and are therefore unavailable. Therefore, the Board concludes that after reviewing the record, we are satisfied that all relevant facts have been properly developed and that no useful purpose would be served by remanding the case with instructions to provide additional assistance to the appellant as it appears that there are no other records that can be obtained. See Gobber v. Derwinski, 2 Vet.App. 470, 472 (1992) (duty to assist does not extend to determinations of whether "there might be some unspecified information which could possibly support a claim."); Wood v. Derwinski, 1 Vet.App. 190, 193 (1991), reconsideration denied, 1 Vet.App. 406 (1991). Service connection may be granted for a chronic disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C.A. § 1131. Service connection may be shown directly or, for certain "chronic diseases" such as cardiovascular disease, presumed if the disease manifested to a degree of 10 percent or more within one year after the date of separation from service. 38 U.S.C.A. §§ 1101, 1112, 1113, 1137. If a disorder is not shown to be chronic during service, continuity of symptomatology after service is required to establish that a disorder is chronic. 38 C.F.R. § 3.303. In this case, it is apparent that the appellant is arguing that his current cardiovascular disorder, claimed as rheumatic valvular heart disease, existed prior to service, and was aggravated therein. In this regard, he has reported and presented sworn testimony that he was treated for rheumatic fever around the age of 5, and as such, suffered from a weak heart prior to entering active service in 1948. He has further argued that this pre-existing “heart condition” was aggravated by active service resulting in hospitalization, permanent restricted duty, and ultimately, discharge. As such, the appellant has repeatedly requested that his current claim be reviewed under the laws and regulations applicable to a pre-existing disorder aggravated by active service. In this regard, the Board finds that neither a cardiovascular disorder or a history of rheumatic fever was “noted” upon examination prior to entry into active duty, but was initially clinically indicated in the early 1960’s. As such, a presumption of soundness attached to the appellant at the time of his entry into active duty. 38 U.S.C.A. §§ 1131, 1111 (West 1991); 38 C.F.R. § 3.304 (1994); Bagby v. Derwinski, 1 Vet.App. 225, 227 (1991). To rebut this presumption, there must be clear and unmistakable evidence that the claimed disability, in this case a cardiovascular disorder, existed before acceptance into service. Id. However, a review of the file reveals absolutely no competent credible evidence that the appellant suffered from a cardiovascular disorder prior to entering active service of during service. In fact, the appellant presented sworn testimony that he did not suffer from any noticeable residuals of reported childhood rheumatic fever up through the time of service enlistment, and available service medical records clearly indicate no complaints or treatment for a cardiovascular disorder or related symptomatology. While the appellant may have had an episode of childhood rheumatic fever, there is simply no evidence that he suffered from a related cardiovascular disorder prior to entry into active service, and is therefore presumed sound in this regard under VA laws and regulations. Available service medical records contain absolutely no complaints, findings or diagnosis of rheumatic heart disease, nor any cardiovascular symptomatology. Specifically, upon examination prior to entry into active service, the appellant denied both a history of and current rheumatism, rheumatic fever, and heart disease, and the accompanying cardiovascular examination was reportedly normal. Clinical service records reflect treatment for suspected appendicitis at William Beaumont General Hospital (WBGH), a right ankle disorder, visual symptomatology, sinusitis, and a emotional instability reaction, with no complaints or evidence of a cardiovascular disorder indicated. Finally, upon examination prior to separation from active service, the appellant’s cardiovascular examination was reportedly normal, and accompanying chest x-rays demonstrated no significant abnormalities. Again, neither a history of or current cardiovascular symptomatology was reported by the appellant or indicated by the attending examiner. The appellant’s DD Form 214 indicates that he was discharged from military service in 1949 pursuant to Army Regulation 615-369, habits and traits of personality not conducive to retention in service. The appellant filed an initial application for entitlement to disability compensation in February 1963, but did not report a history of in-service or post-service cardiovascular disease at that time. However, in conjunction with this claim, the appellant submitted VA treatment records dated in January 1963 indicating a diagnosis of possible rheumatic heart disease. In accord was a March 1963 VA examination report, at which time the appellant reported relevant private medical treatment from Dr. Shumate for “heart” symptomatology since February 1963. An April 1963 statement from Dr. Shumate subsequently submitted by the appellant indicated current treatment for valvular heart disease as well as psychiatric symptomatology. In March 1991, the appellant initially requested entitlement to service connection for a cardiovascular disorder, and reported relevant in-service treatment in support thereof. In this regard, the appellant has repeatedly stated and testified that he was treated for a “weak heart” at WBGH following a fainting spell during basic training, resulting in a permanent profile change and ultimately, discharge. He has further reported relevant private medical treatment for cardiovascular symptomatology since separation from active service to date. As discussed above, all available service and post-service medical reports have been obtained by the RO. The current record contains numerous post-service private and VA inpatient and outpatient medical reports, as well as December 1995 VA examination report, indicating relevant treatment for cardiovascular disease from the early 1960’s, currently diagnosed as follows: rheumatic valvular heart disease, mitral stenosis, status post acute rheumatic fever, status post mitral valve replacement and myomectomy; chronic recurrent atrial fibrillation with multiple episodes of syncope and transient cerebral ischemic attacks; IHSS; cardiomyopathy; arteriosclerotic heart disease with angina pectoris; and congestive heart failure, compensated. Notably, private medical treatment records from Siloam Springs Memorial Hospital dated in March 1965 indicate a reported two year history of treatment for a “heart condition,” while treatment records from Texas Medical Center dated in 1980 indicate a reported 20 year history of treatment for heart disease. In accord are records and reports recently received from the SSA indicating the appellant claimed total disability due to a cardiovascular disorder from September 1962. Private medical statements and reports associated with such a finding from the SSA indicated findings of suspected rheumatic heart disease in January and February 1963, with the date of total disability as a result thereof found to be September 1962. It was also indicated that the appellant had an excellent work history prior to 1962, at which time he was forced to retire due to exertional chest pain and weakness. None of the post-service private or VA records examination reports on file have indicated that the appellant’s cardiovascular disorders were attributable to active service, or to any event or occurrence therein. By a June 1991 rating decision, service connection for a cardiovascular disorder was denied. The appellant was notified of the decision that month, giving rise to this appeal. During a September 1992 personal hearing, the appellant testified that he was treated for childhood rheumatic fever, and was thereafter evaluated for suspected appendicitis and a heart condition at WBGH following a “black-out” during basic training. He further testified that he received private treatment immediately following separation from active duty for relevant cardiovascular symptomatology, from Dr. Shumate, from the early 1960’s from various private physicians whom he could not recall the names and/or addresses, and from the early 1960’s through the VA and from private physicians noted above. Finally, he testified that, in his opinion, his current cardiovascular disease existed prior to entry into active service, and was aggravated by a psychiatric disorder incurred during such service. In November 1994, the Board Remanded this case to the RO in order to obtain additional service and post-service medical records, as well as a current VA examination. As discussed above, all available service medical and personnel records were obtained by the RO, and NPRC indicated in January 1995 that no additional service records, including any reported records from WBGH, could be found or reconstructed. Moreover, all available post-service medical treatment records were obtained by the RO, and the appellant was afforded a December 1995 VA cardiovascular examination. Thereafter, this case was returned to the Board in June 1996. Upon review of all the evidence on file, the Board finds that there is simply no credible evidence on file demonstrating that the appellant incurred a chronic cardiovascular disorder during active service or proximate thereto, or has a current cardiovascular disorder attributable to active service or to any event or occurrence therein. As discussed above, available service medical records contain absolutely no complaints, findings or diagnosis of a cardiovascular disorder, nor any related symptomatology. While such records do indicate that the appellant was treated at WBGH for suspected appendicitis in August 1948, there is no indication that he was found to be suffering from a cardiovascular disorder at that time. In accord are subsequent clinical records as well as the examination upon separation from active service, which demonstrated a normal cardiovascular examination with accompanying x-ray studies. Furthermore, there is no credible evidence on file of a cardiovascular disorder within one year of separation. Moreover, there is absolutely no competent credible evidence or opinion on file that the appellant’s current cardiovascular disorders, initially clinically demonstrated in 1963 by available records, are attributable to active service, or to any even or occurrence therein. The objective credible record clearly demonstrates a history of cardiovascular disease, specifically rheumatic valvular heart disease, from the 1960’s, resulting in total disability for SSA purposes from 1962. As such, service connection therefor is not warranted. Finally, the Board has considered the appellant’s statements and sworn testimony of record pertaining to the etiology of his current cardiovascular disability. Although the appellant's statements are probative of symptomatology, they are not competent or credible evidence of current pathology, medical causation or the date of onset of a disability. Miller v. Derwinski, 2 Vet.App. 578, 580 (1992) (citing Espiritu v. Derwinski, 2 Vet.App. 492, 494-495 (1992)); Grottveit v. Brown, 5 Vet.App. 91, 93 (1993). In the absence of any competent credible evidence demonstrating a chronic cardiovascular disorder during active service or proximate thereto, or a current cardiovascular disorder attributable to active service or to any event or occurrence therein, service connection for said disability is not warranted. ORDER Service connection for a cardiovascular disorder is denied. MICHAEL D. LYON Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, 741 (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991 & Supp. 1995), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402, 102 Stat. 4105, 4122 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals. - 2 -